Tn Dickinsons Medicated Cooling Foam Hemorrhoidal Relief Liquid
NDC Package 52651-057-01

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Tn Dickinsons Medicated Cooling Foam Hemorrhoidal Relief (witch hazel) liquids is adults: when practical, cleanse the affected area with mild soap & warm water and rinse thoroughlygently dry by blotting with toilet tissue or soft cloth before applicationpump once onto toilet paper & if desired, fold to deflate foam. This formulation utilizes a liquid delivery system. Marketed by Dickinson Brands Inc., this product is identified by NDC 52651-057 and is authorized under FDA application M015.

Identification & Billing

NDC Package Code
52651-057-01
Package Description
50 mL in 1 BOTTLE, PUMP
Product Code
52651-057
11-Digit Billing Format
52651005701

Clinical Specifications

Proprietary Name
Tn Dickinsons Medicated Cooling Foam Hemorrhoidal Relief
Non-Proprietary Name
Witch Hazel
Substance Name
Witch Hazel
Dosage Form
Liquid - A dosage form consisting of a pure chemical in its liquid1 state. This dosage form term should not be applied to solutions.
Administration Route
Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.
Active Ingredient(s)
WITCH HAZEL .4 g/mL
Usage Information
Adults: when practical, cleanse the affected area with mild soap & warm water and rinse thoroughlygently dry by blotting with toilet tissue or soft cloth before applicationpump once onto toilet paper & if desired, fold to deflate foam. Apply to affected area by patting then flush. postpartum, add foam on top of each maxi pad for healing relief.use up to 6 times daily or after each bowel movementchildren under 12 years of age: consult a doctor

Regulatory & Marketing

Labeler Name
Dickinson Brands Inc.
Product Type
Human Otc Drug
FDA Application #
M015
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
03-15-2025
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Other Available Packages

The following commercial packages are registered under the same Product NDC (52651-057). Click a package code to view its specific billing and regulatory data.

52651-057-02
147 mL in 1 BOTTLE, PUMP

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 52651-057-01 identifies a specific commercial package of 50 ml in 1 bottle, pump of Tn Dickinsons Medicated Cooling Foam Hemorrhoidal Relief, a human over the counter drug labeled by Dickinson Brands Inc.. This liquid is formulated for topical use and contains witch hazel as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Dickinson Brands Inc. on March 15, 2025. The current certification is valid through December 31, 2026.

How is this Dickinson Brands Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 52651005701. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
52651-057-01
11-Digit CMS (5-4-2)
52651-0057-01

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.